Enzalutamide

Uses	Prostate Cancer
Therapy	Anti-Neoplastic, Hormonal Therapy
Side Effects	Tiredness, Hot Flashes, High Blood Pressure, Falls

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Molecule Description

Enzalutamide is an oral hormonal therapy belonging to the androgen receptor inhibitor class. It works by blocking the action of male hormones (androgens, such as testosterone) that prostate cancer cells use to grow and divide. Prostate cancer cells depend on androgens to grow. Enzalutamide blocks androgens from binding to their receptor, preventing the receptor from moving into the nucleus, and inhibiting its interaction with DNA. This reduces androgen signalling and may help slow the growth of prostate cancer cells. Enzalutamide hould be taken in exact doses under the ongoing supervision of an oncologist or urologist. Enzalutamide is a prescription-only medicine and should be used strictly under medical supervision. The treatment plan is decided by the treating doctor based on the condition being treated, your body response and the other medicines you are receiving. Do not change, stop or repeat a dose on your own. Before starting Enzalutamide, tell your doctor about all your existing medical conditions, especially heart, liver or kidney problems, and about every medicine, vitamin, supplement and herbal product you take. Tell your doctor if you are pregnant, planning a pregnancy or breastfeeding. Regular blood tests and clinical check-ups are usually needed during treatment so that side effects are picked up early.

Uses

Enzalutamide is used to treat advanced prostate cancer

Contraindications

When should one not use Enzalutamide

You have a known severe allergic reaction or hypersensitivity to enzalutamide or any of the inactive ingredients.
It is not indicated for women or children.

Side effects

Common side effects of this drug are:

Significant fatigue, weakness, or feeling overly tired
Hot flashes and sudden feeling of warmth
High blood pressure (hypertension)
Joint pain (arthralgia), back pain, or bone pain
Decreased appetite and weight loss
Constipation or diarrhea
Other Common Side Effects
Dizziness or headache
Falls and fractures
Memory or concentration problems
Anxiety or insomnia
Dry skin, itching, or rash
Swelling in the hands, lower legs, or feet (peripheral edema)
Seizures: Uncontrolled shaking, loss of consciousness.
Posterior Reversible Encephalopathy Syndrome (PRES): sudden severe headache, confusion, vision changes, or seizures.
Ischemic Heart Disease / Cardiovascular Events: Chest pain, shortness of breath, sudden sweating, or signs of a heart attack or stroke.
Severe Falls and Fractures: Instability that can lead to accidental falls and bone injuries.

Precautions and Warnings

Pregnancy

Enzalutamide is not indicated for women. It may cause fetal harm and should not be used during pregnancy. Women who are pregnant or may become pregnant should not handle broken or crushed tablets or capsules without appropriate protection.

Breast Feeding

This medication is not indicated for women.

Driving

Enzalutamide can cause fatigue, dizziness, and, rarely, seizures. Avoid driving or operating machinery if you experience symptoms that could impair your ability.

Alcohol

There is no specific established alcohol interaction with enzalutamide. However, alcohol may worsen dizziness, fatigue, or other side effects. Discuss alcohol use with your doctor.

Other General Warnings

Talk to your doctor if

Consult your doctor if you:
Have a history of seizures, brain lesions, head trauma, or are taking medications that lower the seizure threshold.
Have a history of heart disease, high blood pressure, recent heart attack, or stroke.
Experience sudden vision changes, severe headaches, or severe confusion, which may be symptoms of PRES.
Develop a fall or fracture while receiving treatment.
Take it daily at the same time, as prescribed.
Because enzalutamide can cause dizziness, fatigue, and falls, take extra care when walking or climbing stairs at home.
Inform your doctor if you have a history of seizures, brain injury, stroke, or heart conditions.
If you or your partner could become pregnant, follow your doctor's advice regarding effective contraception during treatment and after the final dose.
Keep out of reach of children and domestic pets.
Dispose of unused or expired medication according to local pharmaceutical waste-disposal recommendations.

Mode of Action

How Does It Work?

Enzalutamide blocks the action of male hormones such as testosterone on prostate cancer cells. These hormones can send signals that help the cancer cells grow. By blocking these signals, Enzalutamide may help slow the growth and spread of prostate cancer.

Interactions

Interactions with other medicines

Some medicines, such as gemfibrozil, may increase the amount of enzalutamide in your body and increase the risk of side effects. Your doctor may adjust your treatment if needed.
Medicines such as rifampicin, carbamazepine, and phenytoin may reduce the amount of enzalutamide in your body and make it less effective. Your doctor may suggest an alternative medicine.
Enzalutamide can make your body break down some other medicines faster, which may make those medicines less effective.
Always tell your doctor about all medicines, vitamins, supplements, and herbal products you take.

Interactions with food items

No specific interactions have been reported

Dosage

Overdose

If you take more than the prescribed dose of Enzalutamide, contact your doctor or seek immediate medical attention. An overdose may increase the risk of adverse effects, including seizures. Treatment is supportive and based on the symptoms.

Missed a Dose

If you missed your dose, take it as soon as you remember. If you miss a dose for an entire day, skip it and resume your usual schedule the next day. Do not take an extra or double dose to make up for a missed one.

Frequently Asked Questions (FAQs)

Your oncologist will determine the duration of treatment based on your type of prostate cancer, response to treatment, and tolerability.

A rising PSA level may indicate disease progression, but PSA is interpreted with symptoms, clinical findings, and imaging when appropriate. Your oncologist will decide whether to continue or change treatment.

Enzalutamide can increase the risk of seizures. If you experience a seizure, seek immediate medical attention. Do not stop or restart treatment on your own; your doctor will decide how to manage treatment.

It may be used with blood pressure medicines, but your doctor should monitor your blood pressure and review potential drug interactions. Enzalutamide can cause hypertension and may affect the effectiveness of some medicines.

Yes. In men with prostate cancer who have not undergone surgical removal of their testicles, androgen deprivation therapy should generally be continued during enzalutamide treatment, as directed by the treating doctor